Mushroom Poisoning with Symptoms of Pantherina Syndrome: A Case Report

Abstract

Introduction: The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning; therefore, emergency physicians should be familiar with it. We present a case of mushroom poisoning that was initially misdiagnosed as a cerebrovascular event.Case Report: A 59-year-old male patient was referred to our emergency service from another hospital with the presumptive diagnosis of a cerebrovascular event. He had presented to the other hospital with complaints of a decrease in consciousness and hallucinations that started 2 h ago. Upon presentation he was unconscious. Family members stated that 30 min before his symptoms started, he had eaten mushrooms that he had collected himself from nature. Active charcoal was administered after gastric lavage. Diazepam was given for agitations. Fifteen hours after the ingestion of mushrooms, the patient was fully conscious. He was monitored for 36 hours and was discharged uneventfully.Conclusion: Pantherina syndrome is a type of mushroom poisoning that has been classified as glutaminergic neurotoxic syndrome with early onset. Treatment is mainly supportive and should be guided by the patient’s symptoms rather than by attempts at mushroom identification. Elimination of the mushroom from the gastrointestinal tract by gastric lavage and the administration of activated charcoal is recommended. Generally, the symptoms are mild and require no further treatment. Emergency physicians should consider mushroom poisoning in the evaluation of patients with acute onset delirium who may be intoxicated by natural substances